Editorial to the Special Issue "The Effect of Exercise Intensity and Psychological Intervention on Musculoskeletal Disorders".

Musculoskeletal disorders are responsible for the most prevalent form of pain, and necessitate a comprehensive approach to rehabilitation [...].

Awake and Sleep Bruxism Prevalence and Their Associated Psychological Factors in First-Year University Students: A Pre-Mid-Post COVID-19 Pandemic Comparison.

There is a broad consensus accepting that psychological variables such as stress, anxiety, or depression play an important role in bruxism. The COVID-19 pandemic has led to an increase in stress, anxiety, and depression levels. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on possible awake and sleep bruxism prevalence and on the psychological factors associated with bruxism, comparing pre-pandemic, pandemic/lockdown, and post-pandemic samples of first-year students. A total of 274 dentistry students from the Complutense University of Madrid participated in the study: 92 from 2018/2019 (pre-pandemic), 90 from 2020/2021 (pandemic), and 92 students from 2021/2022 (post-pandemic) academic years. The participants filled out a thorough battery of validated questionnaires evaluating bruxism and different psychological characteristics, such as anxiety, depression, somatization, personality, and stress coping styles. While sleep bruxism prevalence was significantly higher for the pandemic group, awake bruxism was smaller in comparison to pre-pandemic and post-pandemic groups. The post-pandemic group also presented higher levels of neuroticism and agreeableness personality traits, and positive reappraisal than the pre-pandemic group, with the pandemic group somewhere in between. Additionally, both the pandemic and post-pandemic group showed higher levels of depression and acceptance/resignation coping styles than the pre-pandemic group. Thus, among the three groups of students, the post-pandemic group was the one that showed a larger effect of the pandemic situation in their psychological variables, presenting higher levels of anxiety (state and trait), depression, acceptation/resignation coping style, higher neuroticism (emotional instability trait), and lower agreeableness trait. Nonetheless, the increase of positive reappraisal in the post-pandemic group (an adaptive coping stress style) might be also a sign of recovery. The higher sleep bruxism for the pandemic group might be related to the pandemic situation and lockdown, passively suffered, possibly promoting feelings of impotency, increased levels of depression and acceptance/resignation (normally considered a passive/maladaptive coping style), while acute stressful situations derived from daily personal social interactions might have increased anxiety levels and induced higher levels of awake bruxism observed in both the pre-pandemic and post-pandemic groups. However, further research, including larger and more representative samples, is needed to confirm this possible relationship.

Pulmonary Rehabilitation in SARS-CoV-2: A Systematic Review and Meta-Analysis of Post-Acute Patients.

BACKGROUND: Pulmonary Rehabilitation (PR) was initially developed for the management of Chronic Obstructive Pulmonary Disease (COPD) and is now recognized as a core management of COVID-19 patients. This systematic review and meta-analysis examined the efficacy of PR in patients with post-acute COVID-19 infection. METHODS: A literature search was conducted in PubMed, the Web of Science (WoS), and the Cochrane Library from their inceptions until October 2022, and randomized controlled trials and observational studies were considered. The outcomes measured included dyspnea, physical function, and quality of life. RESULTS: Eleven studies including 677 participants with post-acute COVID-19 were included in this analysis. From a qualitative point of view and analyzing the studies separately, PR improves dyspnea, physical function, and quality of life in patients with post-acute COVID-19. However, in pooling the data of all the studies, no significant changes pre-postintervention, compared to the control, were found among the experimental studies included in the analysis in any outcome measures, due to the high heterogeneity between the studies, as well as no significant improvements being found in the observational studies. A subgroup analysis revealed significant differences in all the included outcomes. Future studies should include the same scale to assess the actual efficacy of PR. CONCLUSION: From a qualitative analysis point of view, PR is effective in improving physical function, reducing dyspnea, and improving quality of life in patients with post-acute COVID-19. However, an exploratory meta-analysis was performed to evaluate, by subgroups, the efficacy of PR, and positive results were found in favor of PR.

Multicomponent Exercise Program to Improve the Immediate Sequelae of COVID-19: A Prospective Study with a Brief Report of 2-Year Follow-Up.

COVID-19 placed teams of professionals in a hostile and unfamiliar environment where the lack of knowledge of its pathology led to the adaptation of programs used so far for other conditions to try to address the immediate sequelae of COVID-19 infection. That is why the aim of this study was to assess the effects of a multicomponent exercise program (MEP) in improving cardio-respiratory performance, health status, disability due to dyspnea, aerobic capacity and endurance, and the immediate sequelae of COVID-19. Thirty-nine patients referred from different hospital services were included in this study. An intervention of seven weeks with sessions twice a week was carried out, where patients underwent intervallic training sessions followed by strengthening exercises and individualized respiratory physiotherapy exercises. The results of this study show a significant improvement in cardio-respiratory performance, health status, disability due to dyspnea, and aerobic capacity and endurance after intervention; and an increase in health status and reduction in disability due to dyspnea at the 2-year follow-up. In addition, none of the patients had any adverse effects either pre-post treatment or at the 2-year follow-up. Individualized and monitored MEP in survivors of COVID-19 showed positive effects in a pre-post evaluation and the 2-year follow up, improving the immediate sequelae of post-COVID-19 patients. This highlights the importance of the professional background of the rehabilitation teams in adapting to an unknown clinical environment.

Dolor musculoesquelético en supervivientes del COVID-19 tras la hospitalización: Una breve revision (Musculoskeletal pain related to COVID-19 survivors after hospitalization: A short review)

Objective: This review aimed to provide an update on the characterization and impact of musculoskeletal pain in COVID-19 survivors. Methods: It is considered articles on subjects who had been recovered from COVID-19 infection after hospitalization (COVID-19 survivors) with secondary musculoskeletal pain. Results: Six articles (one editorial, one consensus statement, one letter to the editor, one case-control study, one cohort study and one review) showed the polyhedral effects of the SARS-CoV-2 on musculoskeletal pain. This short review was not able to clearly identify what the pathogenesis of musculoskeletal pain was in COVID-19 survivors. Conclusion: Preliminary data showed that widespread pain similar to the pattern compatible with pain of musculoskeletal origin could characterize symptoms after SARS-CoV-2 infection. Alternate :Objetivo: Esta revisión tuvo como objetivo proporcionar una actualización sobre la caracterización y el impacto del dolor musculoesquelético en los supervivientes de COVID-19. Métodos: Se consideraron artículos sobre sujetos que se recuperaron de la infección por COVID-19 tras la hospitalización (supervivientes de COVID-19) con dolor musculoesquelético secundario. Resultados: Seis artículos (un editorial, una declaración de consenso, una carta al editor, un estudio de casos y controles, un estudio de cohortes y una revisión) mostraron los efectos poliédricos del SARS-CoV-2 sobre el dolor musculoesquelético. Esta breve revisión no pudo identificar claramente cuál era la patogénesis del dolor musculoesquelético en los supervivientes del COVID-19. Conclusión: Los datos preliminares mostraron que el dolor generalizado similar al patrón compatible con el dolor de origen musculoesquelético podría caracterizar los síntomas después de la infección por SARS-CoV-2.Alternate :Objetivo: Esta revisão teve como objetivo fornecer uma atualização sobre a caracterização e o impacto da dor musculoesquelética em sobreviventes de COVID-19. Métodos: São considerados artigos sobre sujeitos que se recuperaram da infecção por COVID-19 após internação (sobreviventes de COVID-19) com dor musculoesquelética secundária. Resultados: Seis artigos (um editorial, uma declaração de consenso, uma carta ao editor, um estudo de caso-controle, um estudo de coorte e uma revisão) mostraram os efeitos poliédricos do SARS-CoV-2 na dor musculoesquelética. Esta breve revisão não foi capaz de identificar claramente qual era a patogênese da dor musculoesquelética em sobreviventes de COVID-19. Conclusão: Dados preliminares mostraram que dor generalizada semelhante ao padrão compatível com dor de origem musculoesquelética pode caracterizar sintomas após infecção por SARS-CoV-2.

Spanish experience on the efficacy of airways clearance techniques in SARS-CoV-2 (COVID-19) at intensive care unit: An editorial and case report.

COVID-19 pandemic did not impact all countries in the same way, and in Spain, the percentage of intensive care unit (ICU) and the mortality rate patients has been very high. The present work aims to present the first case of the new Coronavirus-2019 (COVID-19) on March 23, 2020, in Tenerife, Canary Islands, Spain, of a patient on Invasive Mechanical Ventilation (IMV) affected by acute pneumonia which was treated by airway clearance techniques (ACT) thinking that she was not infected with COVID-19, since the first polymerase chain reaction (PCR) test was negative. The subject presented septic shock, hypoxemic encephalopathy, and seizures. Right lung base consolidation and pleural effusion were visible in the echography. The thorax x-ray presented subcutaneous emphysema and pleural effusion in the right base and an alveolar-interstitial opacity pattern in the left. Bilateral crackles and rhonchus were evident in the right lung during the lung auscultation. The airway clearance protocol comprises Cough Assist (CA) and chest compressions. The variables collected were the ventilatory parameters, blood gas analysis, and thorax x-ray description. ACT protocol improves gas exchange and expands consolidated lung areas in this atypical clinical case presented. At that time, this type of treatment was not performed on patients affected by COVID-19, and the next day we found that the patient had improved, coinciding with the second PCR test, which was positive.

Effects of a Multicomponent Exercise Program on Improving Frailty in Post-COVID-19 Older Adults after Intensive Care Units: A Single-Group Retrospective Cohort Study.

BACKGROUND: Older adult patients with post-COVID-19 syndrome present greater physical impairment accompanied by frailty than younger patients, which is why multicomponent exercise programs (MEP) are recommended for their positive effects on improving frailty and physical capacity. The aim of this study was to evaluate the effects of a short MEP (Vivifrail; <4 weeks) on improving frailty in post-COVID-19 older adults after intensive care units. METHODS: To develop a retrospective cohort study, data were collected from the functional gait training program based on selected Vivifrail MEP in a single-group and applied to patients admitted with a diagnosis of post-COVID-19 functional impairment. The MEP was carried out for 3 weeks, with daily sessions lasting 40 min. Patients included were assessed at the beginning and at the end of the protocol by using the Short Performance Physical Battery (SPPB), the number of falls in the last year, the number of falls with medical attention, the Timed Up and Go (TUG) test, the presence of dementia, the Trunk Control Test (TCT), the Tinetti balance and gait test, Barthel Index, Medical Research Council Sum Score (MRCSS) and handgrip strength dynamometry. RESULTS: The results of this study show statistically significant improvements in physical fitness and frailty with increases in the Short Physical Performance Battery (Z = 9.12, p < 0.001) by means of the MET applied in its short version (<4 weeks) showing even clinically relevant improvements (>2.5 points). Statistically significant improvements were also found in Medical Research Council Sum Score (Z = 12.345, p < 0.001), Barthel Index Score (Z = 12.272, p < 0.001), Trunk Control Test (Z = 12. 36, p < 0.001), Tinetti-POMA (Z = 12.293, p < 0.001) including the balance (Z = 12.11, p < 0.001), gait (Z = 12.164, p < 0.001) subscales and in the hand dynamometry (Z = 12.172, p < 0.001). CONCLUSIONS: The selected Vivifrail MEP is effective and safe for improving frailty in post-COVID-19 older adult's patients.

Reliability of Sonography Measures of the Lumbar Multifidus and Transversus Abdominis during Static and Dynamic Activities in Subjects with Non-Specific Chronic Low Back Pain.

PURPOSE: The purpose of this study was to investigate the test-retest reliability of ultrasound (US) thickness measurements and the muscle contraction ratio (CR) of lumbar multifidus (LM) and transversus abdominis (TA) muscles in participants with and without nonspecific chronic low back pain (NCLBP). METHODS: A total of 62 participants (37 with NCLBP, 25 without NCLBP) with participated in the study. The within-day and between-day reliability of US thickness measurements and CR in a lying (supine for TA and prone for LM) and sitting positions for both muscles (sitting on a gym ball with both feet on the ground or lifting one foot off the floor) were assessed. Reliability analysis was performed with intraclass correlations (ICCs) for these two static and dynamic positions. RESULTS: Test-retest reliability was calculated to be good to high for the static position (ICC = 0.72-0.95) and the dynamic position (ICC = 0.74-0.94) sonographic measurements in both group of TA measurement. Test-retest reliability of LM measurements was good to high for the static position (ICC = 0.82-0.95) and the dynamic position (ICC = 0.85-0.97) sonographic measurements in both groups. CONCLUSIONS: US imaging is a highly reliable method for the assessment of TA and LM thickness muscles in the dynamic position in participants with and without NCLBP. The CR measures may be adequately reliable in assessing the function of the TA and LM muscles in participants with NCLBP and healthy ones.